Peritonitis is an infectious disease of the abdomen. It is a serious condition that can be life-threatening and requires immediate treatment.
What is the peritoneum?
The word peritonitis means infection of the peritoneum. To better understand what it is, we must explain a little what the peritoneum is.
This structure is a membrane that covers the inside of the abdomen, it is arranged in such a way that it covers the inside of the muscles that form the abdominal wall.
In the posterior wall, the peritoneum sends out extensions that fold over each and every organ to cover them and form ligaments that help hold each organ in place. In the case of the small intestine, the peritoneum forms a structure called the mesentery.
The peritoneum has two sheets, between which is a very small amount of fluid that allows the movement of one over the other.
What is peritonitis and why does it occur?
When the bacteria reach the peritoneal membrane, inflammation occurs, which we know as peritonitis. These bacteria come mainly from the intestinal tube or from outside the body.
The bacteria outside the body enter through wounds which should be deep and reach the peritoneal membrane. This occurs in the case of stab wounds, gunshot wounds, or cutting or puncture injuries that accompany the various types of accidents.
Another form of peritonitis occurs as a complication of diseases of the digestive tract in which the perforation of a viscus occurs, as is the case of stomach perforation due to a gastric ulcer, of the gallbladder due to problems such as cholecystitis (infection of a full gallbladder of stones), a diverticulum of the colon or a ruptured appendix affected by appendicitis.
Perforations can also occur as complications of diagnostic procedures such as endoscopies (gastroscopy, colonoscopy, cystoscopy, etc.), in expert hands this complication is very rare.
The cancer is a lesion that can invade the wall of the structure in which it is located can cause perforations that cause peritonitis.
It is also possible for peritonitis to occur without infection. This happens in people with immune diseases in which antibodies are produced against their own tissues (autoimmunity). A common case is Lupus, a disease in which the body's membranes are affected, mainly the peritoneum, the pleura (which covers the chest and lungs) and the pericardium (the membrane that covers the heart).
Symptoms of peritonitis
Inflammation of the peritoneum is an extremely painful condition.
A person with peritonitis has as the first manifestation very strong pain in the abdomen, initially the area where the problem originated hurts (upper right part of the abdomen for gallbladder lesions, lower left in the case of diverticula or part lower right when it comes to appendicitis).
As the hours go by, the infection spreads and the entire abdomen may ache, here other symptoms appear such as decay and fever, there may also be loss of appetite, nausea and vomiting.
An important manifestation, which is looked for when examining patients, is the hardening of the abdomen, there is a lot of defense of the patient when examining it. The inflamed peritoneum contracts the muscles of the abdomen.
Fever and fluid loss into the abdominal cavity can lead to dehydration. For this reason, it is common for the person to have dry mucous membranes, sunken eyes, and produce less urine.
A person with peritonitis is recognized because he is lying down, immobile, with his legs bent, the slightest movement aggravates the pain. This attitude is very characteristic.
Treatment of peritonitis
Treatment depends on the root cause.
The immunological peritonitis may merit drain liquids through a puncture and treatment with medications that slow the activity of the immune system.
Peritonitis due to perforation or wounds warrant the use of antibiotics and surgery. Loa antibiotics attack bacteria, surgery allows to repair injuries such as intestinal perforations or wounds in the wall of the abdomen, wash the abdominal cavity and close the peritoneum again
Surgery is generally performed on an emergency basis, since peritonitis can be complicated by the development of a generalized infection, a state known as sepsis, which has a high mortality rate if it is not resolved in a timely manner.
The earlier peritonitis treatment is carried out, the more likely it is to avoid serious complications.
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